According to an analysis by the U.S. Centers for Disease Control and Prevention (CDC), cigarette smoking and exposure to tobacco smoke cause at least 443,000 premature deaths each year in the United States alone. These results, based on data from 2000-2004, were published in the Morbidity and Mortality Weekly Report.

Smoking substantially increases the risk of death from cancer, cardiovascular disease, and chronic obstructive pulmonary disease. In the case of lung cancer, the leading cause of cancer death among both men and women in the United States, smoking is thought to be responsible for 80-90% of all deaths. Smoking also contributes to head and neck cancer, esophageal cancer, and bladder cancer.

Exposure to secondhand smoke also carries dangers. Secondhand smoke is classified as a known human carcinogen by the U.S. National Toxicology Program as well as the International Agency for Research on Cancer. It contains at least 250 chemicals that are known to be toxic or carcinogenic.[1] And in addition to causing cancer, secondhand smoke has clear adverse effects on the respiratory and cardiovascular systems.

To evaluate the health burden of smoking and exposure to tobacco smoke, researchers at the CDC linked information from the National Health Interview Survey with death certificate data from the National Center for Health Statistics.[2] The analysis focused on the most recent time period available: 2000-2004.

Each year cigarette smoking or exposure to tobacco smoke were responsible for:

• A total of at least 443,000 premature deaths
• 776 infant deaths (as a result of smoking during pregnancy)
• 736 deaths due to smoking-attributable residential fires
• 49,400 deaths from lung cancer or heart disease caused by secondhand smoke.
• Approximately 5.1 million years of potential life lost
• $96.8 billion in productivity losses

The leading causes of death from smoking were lung cancer, ischemic heart disease, and chronic obstructive pulmonary disease.

Comments: This report highlights the importance of ongoing smoking cessation and tobacco control efforts.

References:

[1] Report on Carcinogens, Eleventh Edition; U.S. Department of Health and Human Services, Public Health Service, National Toxicology Program.  Available at: http://ntp.niehs.nih.gov/ntp/roc/eleventh/profiles/s176toba.pdf.  Accessed April 14, 2009.

[2] Centers for Disease Control and Prevention (CDC). Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses --- United States, 2000—2004. MMWR Morb Mortal Wkly Rep. 2008 Nov 14;57(45):1226-8.